This is the fifth post in an ongoing series on the 5-stage grieving process experienced by those caring for a person with COPD. It's not easy being a caregiver for someone with COPD. Watching them slowly lose the person they once were is extremely tough to live through. Losing hope is almost inevitable, at least some of the time.

The next stage in the grieving process, after bargaining, is often depression. At this stage, you finally allow yourself to feel the loss, or impending loss, fully. You accept that things are never really going to get better. In fact, they are probably going to get worse. Maybe not today or tomorrow, but soon.

Don't forget that each stage of grieving is perfectly natural and OK. Feeling the way you do is nothing to be ashamed of. It's a coping mechanism and something each of us goes through as caregivers.

Also, remember that while many people progress through the stages step by step as I've laid them out in this series, others go through them in a different order, skip stages or go back & forth several times between stages. Think of grieving as more of a roller coaster than a straight pathway. It doesn't matter how it happens for you; it's all good. The important thing is to recognize where you are in the process day by day and then to deal with it in as healthy a fashion as you can. After all, your loved one with COPD is relying upon you.

In the depression stage of grieving, there is a turning inward. You finally allow yourself to feel the sadness and despair of not being able to prevent the inevitable outcome of COPD. You realize that no matter how angry you got, how much you refused to believe it, or what bargains you tried to strike with fate, your God, or the universe, you couldn't change the fact that your loved one has COPD, a chronic, incurable illness.

It's a tough pill to swallow and most of us retreat into solitude for at least a time. You will probably spend time thinking about the "good old days", focusing on past memories and special times with your loved one. It is common to have feelings of emptiness and to feel intense emotional pain.

Signs that you have entered the depression stage include:

• Isolating yourself from others; you allow your caregiving to exclude everything else
• Difficulting concentrating when awake & sleeping at bedtime
• Spending time sleeping or other solitary activities & avoiding social contacts
• Feeling apathetic or numb & lacking the capacity for joy
• Emotions are on a hair trigger; laughing too loud and crying too easily
• Experiencing low energy

Tips for Coping During the Depression Stage of Grieving

Moving through depression is a necessary step on the way to acceptance of your loss. It's not fun, but it is normal and something you DO have to go through. So don't fight it, but do take steps to keep moving forward, even if it's very slowly.

It's not helpful for others to urge you to "cheer up" or stop feeling the way you do. So help them see that what you're going through is necessary. Ask them to be there for you and to keep inviting you to socialize periodically, but not to harrass you if you need some time alone.